Nurses’ Compliance to Enhanced Infection Prevention and Control Protocols for Covid-19 in the Critical Care Unit at Kenyatta National Hospital

Abstract

Background: The health care system has been adversely affected by corona virus infection and as a result nurses have been tasked with the burden of caring for an increased number of patients. Health care workers are at a higher risk of contracting infection of corona virus and so it is important that the nurses comply to the infection prevention and control protocols. Compliance of nurses to IPC protocols has become a challenge in some institutions, yet it is very vital in the control and prevention of infections. The main approach to COVID-19 infections is mainly adhering to infection prevention and control measures. Although IPC practices were in place before COVID 19, there was need to enhance these measures after the emergence of the corona virus and therefore implementation strategies of adhering to IPC measures should be put in place. Objective: Assessing nurses’ compliance to enhanced IPC protocols for COVID-19 in the critical care units at the Kenyatta National Hospital. Methods: The study population were nurses working in the critical care unit at Kenyatta National Hospital. Descriptive cross sectional study was used. A sample size of 151 critical care nurses working in the different critical care units at Kenyatta National Hospital were recruited and provided with self-administered questionnaires. Structured observational checklists were used to assess for compliance of nurses to IPC COVID -19 enhanced protocols. In order to sample nurses who participated in the study, I used proportionate stratified random sampling so that each stratum had the same sampling fraction. Simple random sampling method was then used within each stratum, where the researcher randomly selected participants using random number method and data was collected. The data collected was entered, coded and managed. Analysis of data was done using quantitative data in descriptive and inferential statistics in STATA statistical software version 26 and data was presented using tables. Results: 151 nurses took part in the study. Most of the nurses complied with the protocols on proper hand hygiene though with a few exceptions in regards to application of moments of hand hygiene method and steps of hand hygiene. There was compliance in use and disposal of personal protective equipments (PPEs) including surgical masks, gloves, head gear and gowns. All (100%) of the nurses also ensured that patients observed the 1.5m social distance spacing rule. All (100%) of the nurses were also found to be compliant with protocols on use of pedal operated coded bins for proper waste management, proper segregation/separation of clean and dirty linen and proper storage of sterile instruments. Availability of quality and adequate PPEs (72.8%, p = .000) and Proper training on COVID-19 enhanced IPC protocols (29.1%, p = .000) significantly influenced the nurses’ compliance to the enhanced IPC protocols. Conclusion: Nurses working in the critical care units at KNH were highly compliant with the enhanced IPC protocols for COVID-19. Availability of quality and adequate PPEs, their knowledge of the COVID-19 enhanced IPC protocols and proper training on these protocols influenced their compliance with the enhanced IPC protocols. Recommendations: KNH should ensure that each critical care unit has the enhanced IPC guidelines for COVID-19 as standards of operations for its critical care nurse.